title: Mediterranean and DASH diet scores and mortality in women with heart failure: The Women's Health Initiative.
abstract: BACKGROUND
  Current dietary recommendations for patients with heart failure (HF) are largely based on data from non-HF populations; evidence on associations of dietary patterns with outcomes in HF is limited. We therefore evaluated associations of Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diet scores with mortality among postmenopausal women with HF.
  
  
  RESULTS
  Women's Health Initiative participants were followed up from the date of HF hospitalization through the date of death or last participant contact before August 2009. Mediterranean and DASH diet scores were calculated from food-frequency questionnaires. Cox proportional hazards models adjusted for demographics, health behaviors, and health status were used to calculate hazard ratios and 95% confidence intervals (CI). For a median of 4.6 years of follow-up, 1385 of 3215 (43.1%) participants who experienced a HF hospitalization died. Multivariable-adjusted hazard ratios were 1 (reference), 1.05 (95% CI, 0.89-1.24), 0.97 (95% CI, 0.81-1.17), and 0.85 (95% CI, 0.70-1.02) across quartiles of the Mediterranean diet score (P trend=0.08) and 1 (reference), 1.04 (95% CI, 0.89-1.21), 0.83 (95% CI, 0.70-0.98), and 0.84 (95% CI, 0.70-1.00) across quartiles of the DASH diet score (P trend=0.01). Diet score components, vegetables, nuts, and whole grain intake, were inversely associated with mortality.
  
  
  CONCLUSIONS
  Higher DASH diet scores were associated with modestly lower mortality in women with HF, and there was a nonsignificant trend toward an inverse association with Mediterranean diet scores. These data provide support for the concept that dietary recommendations developed for other cardiovascular conditions or general populations may also be appropriate in patients with HF.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT00000611.
authors.affiliation: University of Alabama at Birmingham.
authors.forename: Emily B
authors.initials: EB
authors.lastname: Levitan
authors.forename: Cora E
authors.initials: CE
authors.lastname: Lewis
authors.forename: Lesley F
authors.initials: LF
authors.lastname: Tinker
authors.forename: Charles B
authors.initials: CB
authors.lastname: Eaton
authors.forename: Ali
authors.initials: A
authors.lastname: Ahmed
authors.forename: JoAnn E
authors.initials: JE
authors.lastname: Manson
authors.forename: Linda G
authors.initials: LG
authors.lastname: Snetselaar
authors.forename: Lisa W
authors.initials: LW
authors.lastname: Martin
authors.forename: Maurizio
authors.initials: M
authors.lastname: Trevisan
authors.forename: Barbara V
authors.initials: BV
authors.lastname: Howard
authors.forename: James M
authors.initials: JM
authors.lastname: Shikany
mesh_terms: D000368:Aged; D016001:Confidence Intervals; D038441:Diet, Mediterranean / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000178:diet therapy* / Q000401:mortality; D006801:Humans; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology; D016387:Women's Health
keywords: diet; heart failure; mortality; nutrition